Shimada Taketoshi, Matsui Masahiro, Ikebuchi Kaichiro, Nakano Hiroshi, Shinomiya Takashi, Nakai Shigeru, Hisa Yasuo
Department of Otolaryngology, Head and Neck Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-0841, Japan.
Auris Nasus Larynx. 2007 Jun;34(2):277-9. doi: 10.1016/j.anl.2006.09.009. Epub 2006 Nov 2.
Multiple myeloma, solitary plasmacytoma, and extramedullary plasmacytoma constitute a continuous disease spectrum of plasma cell neoplasms. In the larynx, although extramedullary plasmacytoma in the supraglottic region has been sometimes reported, plasma cell neoplasm with involvement of the thyroid cartilage is extremely rare. We report a case of multiple myeloma involving the thyroid cartilage. A 72-year-old male patient presented with a pathological fracture of the cervical vertebrae. CT scan revealed low-density areas within the thyroid cartilage, but the laryngeal mucosa and submucosal soft tissue were intact. Multiple myeloma was diagnosed, since the tumors in the thyroid cartilage and cervical vertebrae revealed plasmacytoma. Because no other lesion was found, irradiation of the larynx and cervical vertebrae was performed. Neither aggressive change of these lesions nor new lesions have been found over 3-year follow-up following the initial treatment without adjuvant therapy.
多发性骨髓瘤、孤立性浆细胞瘤和髓外浆细胞瘤构成了浆细胞肿瘤的连续疾病谱。在喉部,虽然有时会报道声门上区的髓外浆细胞瘤,但累及甲状软骨的浆细胞肿瘤极为罕见。我们报告一例累及甲状软骨的多发性骨髓瘤病例。一名72岁男性患者出现颈椎病理性骨折。CT扫描显示甲状软骨内有低密度区,但喉黏膜和黏膜下软组织完整。由于甲状软骨和颈椎的肿瘤显示为浆细胞瘤,故诊断为多发性骨髓瘤。因未发现其他病变,遂对喉部和颈椎进行了放疗。在初始治疗后未进行辅助治疗的3年随访中,这些病变既没有出现侵袭性变化,也没有发现新的病变。